Peripheral Neuropathy: A Rundown

Your peripheral nervous system is in charge of sending information from your central nervous system (brain and spinal cord) to the rest of your body. The peripheral nerves also send sensory information to the nervous system. There have been more than 100 types of peripheral neuropathy identified, each with their own unique symptoms and prognosis, and the symptoms vary on what type of nerves are damaged, either the motor, sensory, or autonomic nerves.

Motor nerves control how our muscles move under conscious control, meaning things like walking, talking, holding things, and performing physical activities Sensory nerves transmit information that relate to the senses: touching, temperature, or acute pain. Autonomic nerves control all of the involuntary functions of our body such as breathing, digesting food, and gland and heart functions.

It has been found that peripheral neuropathy often affects all three types of nerve fibers to different degrees, but with most symptoms being present in two nerve types (for example: primary pain in motor and sensory nerves, while minimal pain in autonomic nerves), and you doctor will use terms such as “predominantly motor neuropathy” etc., to describe different conditions.

Peripheral neuropathy, one of the most common types of neuropathy in EDS/HSD patients, is caused by damage to the nerves outside of the brain and spinal cord. This can cause weakness, numbness, and pain, usually in your hands and feet. There have been studies done from 1995-2016 exploring the connection between connective tissue disorders such as EDS and neurological manifestations including small fiber neuropathy and peripheral neuropathy.

In a study from the Iranian Journal of Neurology from October of 2014, it was found that the peripheral neuropathy in EDS patients is related to the dislocations and subluxations (can be classified as physical injury or trauma) that cause abnormal stretching or pressure on the peripheral nerves. They also believe that the underlying genetic defect involved with Collagen I, III, and V may cause the tissue of the peripheral nerves to fail or resist stress, causing neuropathic pain.

More generally, vascular and blood problems (vasculitis, blood vessel wall thickening), high blood pressure, autoimmune disorders, hormonal imbalances, kidney and liver disorders, vitamin or nutritional imbalances, and sometimes certain cancers can all lead to peripheral neuropathy.

Signs and symptoms of motor nerve damage is most commonly associated with muscle weakness, but can also include cramps, uncontrolled muscle twitching, and muscle shrinking,

For sensory nerve damage, it's a bit more complicated, as it can cause many different symptoms since sensory nerves have a lot of jobs. There are large sensory fibers and small fibers, and both contribute to different symptoms. Large fiber damage hinders the ability to feel vibration and touch, mostly in the hands and feet, in addition, it can contribute to lack of proprioception, and make complex movements like walking, balancing, and fastening buttons with eyes closed difficult or unattainable. The small fibers transmit pain and temperature sensations, and damage to these can interfere with one’s feeling of temperature change and pain.

Autonomic nerve damage primarily affects the axons in small fiber neuropathy, and causes symptoms such as sweating in excess, heat intolerance, inability to regulate blood pressure, gastrointestinal dysfunction. But rarely, some develop issues eating or swallowing if the nerves that control the esophagus are impacted.

If you believe you have symptoms of nerve pain or peripheral neuropathy, be sure to consult with your primary care physician or other medical professionals in regards to your medical concerns. This text cannot and should not replace advice from the patient's healthcare professionals. Any person who experiences unusual symptoms or feels that something may be wrong should seek individual professional help for evaluation and/or treatment, or call emergency services.